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Mantzouranis K, Georgakopoulou VE, Mermigkis D, Damaskos C, Garmpis N, Papalexis P, Gkoufa A, Drossos P, Chlapoutakis S, Garmpi A, Sklapani P, Trakas N, Tsiafaki X. Staphylococcus aureus mediastinitis following a skin infection in a non-immunocompromised patient: A case report. Biomed Rep 2021; 15:104. [PMID: 34760277 PMCID: PMC8567464 DOI: 10.3892/br.2021.1480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2021] [Accepted: 10/12/2021] [Indexed: 11/06/2022] Open
Abstract
Mediastinitis is a severe inflammation of the structures located in the mid-chest cavity. Three main causes of infective mediastinitis are traditionally recognized: Deep infection of a sternal wound following cardiothoracic surgery, perforation of the esophagus, and the descending necrotizing mediastinitis as a result of odontogenic, pharyngeal or cervical infections. Mediastinitis, as a complication of skin infection with hematogenous spread is infrequent. Methicillin-resistant Staphylococcus aureus (MRSA) is a gram-positive bacteria, and is responsible for numerous severe infections. MRSA mediastinitis is a rare infection and is typically associated with complications of sternotomy and retropharyngeal abscesses. Here, the second known case of mediastinitis of a hematogenous origin in a non-immunocompromised 41-year-old patient following primary skin infection, accompanied by sternal osteomyelitis, lung consolidation and pleural effusion is described; MRSA was the responsible pathogen. The clinical course was favorable after 6 weeks of antibiotics administration without drainage or surgical intervention.
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Affiliation(s)
| | | | | | - Christos Damaskos
- Renal Transplantation Unit, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.,N.S. Christeas Laboratory of Experimental Surgery and Surgical Research; Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Nikolaos Garmpis
- N.S. Christeas Laboratory of Experimental Surgery and Surgical Research; Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.,Second Department of Propedeutic Surgery, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Petros Papalexis
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece.,Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | - Aikaterini Gkoufa
- First Department of Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Panagiotis Drossos
- Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece
| | | | - Anna Garmpi
- First Department of Propedeutic Internal Medicine, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Pagona Sklapani
- Department of Cytology, Mitera Hospital, 15123 Athens, Greece
| | - Nikolaos Trakas
- Department of Biochemistry, Sismanogleio Hospital, 15126 Athens, Greece
| | - Xanthi Tsiafaki
- 1st Pulmonology Department Sismanogleio Hospital, 15126 Athens, Greece
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Staphylococcus aureus Descending Necrotizing Mediastinitis in a Healthy Adult. Ann Thorac Surg 2020; 111:e397-e398. [PMID: 33290738 DOI: 10.1016/j.athoracsur.2020.09.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 09/01/2020] [Indexed: 10/22/2022]
Abstract
Descending necrotizing mediastinitis (DNM) is a severe form of mediastinitis with high mortality rates due to the rapid progression of infection into the mediastinum through tissue planes, often from a dental or pharyngeal source. We present a case of monomicrobial methicillin-resistant Staphylococcus aureus DNM in a healthy young man who was initially misdiagnosed with strep throat. This is well described in the pediatric literature; however, DNM in adults is typically polymicrobial and occurs in those with comorbidities such as diabetes mellitus and older age. Survival is excellent with early identification of mediastinitis, prompt surgical intervention, and appropriate antibiotics.
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Rodríguez Gutiérrez AF, Giraldo A. Piomiositis del músculo Esternocleidomastoideo. Rerpote de un caso en Colombia y revisión de la literatura. REVISTA DE LA FACULTAD DE MEDICINA 2015. [DOI: 10.15446/revfacmed.v62n3.44196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Lin FCF, Jeng KC, Tsai SCS. Oesophageal pyomyositis in an intravenous drug user. Interact Cardiovasc Thorac Surg 2014; 19:867-8. [PMID: 25125141 DOI: 10.1093/icvts/ivu269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
An inflammatory or infectious disease of the oesophagus occurring in tissue layers beneath but sparing the mucosa may pose a diagnostic challenge. Bacterial pyomyositis has been previously reported occurring mostly in the skeletal muscle. Pyomyositis involving the gastrointestinal tract is extremely rare, and may easily be misdiagnosed due to its nonspecific clinical features. We report a case of an intravenous drug user who presented with oesophageal pyomyositis. Early computed tomography facilitated accurate diagnosis. Adequate drainage followed by antibiotic treatment was effective and the oesophagus was preserved. To the best of our knowledge, this is the first report of a case of oesophageal myositis in an intravenous drug user.
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Affiliation(s)
- Frank Cheau-Feng Lin
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Thoracic Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Kee-Ching Jeng
- Department of Medical Research, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan
| | - Stella Chin-Shaw Tsai
- Department of Medical Research, Tung's Taichung MetroHarbor Hospital, Taichung, Taiwan Department of Food and Nutrition, Providence University, Taichung, Taiwan
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